Individual
DR. JASON T KOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13249 CASCADE GLEN DR, DRAPER, UT 84020-7146
(801) 572-5226
Mailing address
13249 CASCADE GLEN DR, DRAPER, UT 84020-7146
(801) 572-5226
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
M1188
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173049102
—
TX
Enumeration date
07/17/2006
Last updated
07/05/2010
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